- advertisement -

Daughter overweight and struggling

Discussion in 'Parents of Teens' started by cmckinney, May 21, 2013.

  1. cmckinney

    cmckinney New Member

    Joined:
    May 21, 2013
    Messages:
    1
    My 13 year old daughter was diagnosed a year ago. She has since gained almost 50 lbs, putting her at 5'3" and almost 200 lbs. She seems to be always hungry ( as teens often are) and I struggle with limiting her intake when she is miserable. She has now started sneaking food into her room and eating without covering her carbs. She is 2 weeks away from starting on the Animas One touch Ping pump, and she has been having some crazy highs (418 fasting this am, but 193 yesterday at dinner).
    Will this even out once she is on the pump? Any ideas how to motivate her to decrease her intake? She is not sedentary, she is very high energy and plays outside with siblings all the time.
    Thanks for the help, this is my first attempt at this....
     
  2. Mish

    Mish Approved members

    Joined:
    Aug 20, 2009
    Messages:
    1,393
    Has the endo addressed this issues? The problem is that at this weight she's going to become insulin resistant if not develop full blown type 2 in addition to type 1. It's known as double diabetes.

    The problem is that she's always high, which makes her always hungry which leads to sneaking food which leads to being high. The best way to break it is to limit her food intake. That's the only real way you're going to tackle this. At 13, she's well off the weight chart. The high end of weight 95% is only 158. Her height only puts her at the 75%.

    Since a 13 year old isn't shopping for groceries and stocking the house, I think the burden falls to you to simply not buy the junk she's eating and sneaking and only preparing healthy meals in normal sized portions. I'd also ask your pediatrician or your endo clinic to enroll her in a program specifically for overweight teens.

    Good luck.
     
  3. danismom79

    danismom79 Approved members

    Joined:
    Apr 21, 2008
    Messages:
    5,300
    I agree with all of this. See if your endo dept also has a nutritionist on staff, and maybe a social worker to figure out why she feels the need to sneak food. What is her insulin regimen? Is she not wanting to take extra shots to cover food, or are her meals limited by her regimen?

    The pump is not a device that will automatically "even things out." It only does what you tell it to do. If she's avoiding extra shots, it will be easier for her to bolus for all the food she eats. But you first want to figure out why and how she gained so much weight over the year.

    Also, are you checking for ketones? It sounds like she's going without sufficient insulin for long periods of time.
     
  4. mocha

    mocha Approved members

    Joined:
    Feb 27, 2011
    Messages:
    430
    Honestly, I think part of the problem is that there is shaming about her food consumption. Of course she's going to sneak food and not cover it if people are shaming her about eating and her weight.

    Talk to her doctors. If they aren't concerned, then don't worry about it. Ask her how she feels about it. If she or her doctors want to address the issue, then make a game plan with her. Talk to her about making sure that she's satisfied and eating healthy. Eating healthy should be the main goal anyway.
     
  5. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    Welcome! I am so sorry you are having a tough time.

    A few questions (feel free to answer as few or as many as you want :cwds:) and then I have a few suggestions.
    1. What is her TDD? That is the total number of units insulin she gets each day (so add the long acting and short acting together).

    2. Has she gotten her period yet? If so do the highs and eating have any correlation to where she is in her cycle?

    3. How is she handling the diagnosis emotionally?

    4. What was her last A1C?

    I would guess she is very resistant to insulin because of a combination of her weight and the constant high blood sugars. I dealt with that as well as a teenager due to puberty and steroids. Metformin is a simple and relatively low risk drug that can be really helpful. I was using 90 units of insulin a day and metformin dropped my total daily dose down to under 30 units. Symlin is another option but it is a shot before any meal with a high carb count. It does come with the risk of severe lows and I would think it would be complicated to start around the time you are starting a pump. Both metformin and symlin have been shown to result in weight loss in several studies.


    I am not really qualified to offer any parenting advice but I can provide my perspective as a teen. In terms of food, I guess I would encourage you to have healthy foods around. It might be useful to take your daughter to the grocery store and have her pick out the healthy food she likes. I also like eating food I cooked myself so maybe having her look up healthy recipes, make a shopping list, and cook the meal would inspire her to eat healthier foods. I think it would have to be done in a subtle way because I am sure she is very sensitive about her weight.

    I would guess it would be easier for her doctors to talk to her about this then you. I would be very upset if my parents offered any opinion on my weight because I would feel as though they were disappointed in me. Your daughter may feel differently but I think most teens underweight, normal, or overweight tend to be a bit sensitive to how they look. Depending on her relationship with her pediatrician that might be a good place to start. I know there are also doctors that specialize in adolescents but I am not sure about your location.

    Here are a few articles about Metformin and symlin in type 1:

    http://link.springer.com/article/10.1007/s00125-009-1636-9/fulltext.html#Sec3

    http://forecast.diabetes.org/magazine/features/symlin-close

    http://spectrum.diabetesjournals.org/content/19/1/50.full

    http://www.dovepress.com/review-of-...ment-of-type-1-and-peer-reviewed-article-DDDT

    Good luck!

    ETA:

    I know you are getting the animas ping pump. Did you also look at the tslim or medtronic 723? While the Animas is a great option my concern is it is a 200 unit reservoir instead of the 300 units for the other two. I would guess your daughter is using well over one hundred units of insulin a day which after priming means it is quite likely you will be changing the reservoir on a daily basis (if not more frequently..) which will probably get annoying very quickly. Just a small thought..
     
    Last edited: May 21, 2013
  6. Mish

    Mish Approved members

    Joined:
    Aug 20, 2009
    Messages:
    1,393
    Meg and Kristen,
    I know you're approaching it from your end as teens yourself, but I'm not sure if you guys realize just how overweight this child is. We're not talking about simply chubby kid. If her weight and height were proportional she'd be about 115lbs. 200lbs puts her well, well well off the charts with a BMI around 35. We're talking morbidly obese. Not just 'sensitive about weight'.

    Some serious intervention is needed is needed on the part of the parents and doctors. A kid this age who is already eating far too much food really is past the point of saying that simply helping her to make healthy eating choices is what's needed. The time for a gentle approach was when she was only at the 90% for weight.
     
  7. RomeoEcho

    RomeoEcho Approved members

    Joined:
    Dec 22, 2008
    Messages:
    483
    I was very overweight in my early 20s. "Advice" from my parents at that point wasn't very useful. Support, yes, but teens tend to think their parents don't know enough about them. I second the opinion that she needs to hear it from a doctor more than you. I'd also see about getting her into counseling since eating at that rate is usually an emotional eating thing not physical hunger, though she probably perceives it as hunger.

    Other than that, I'd look into weight watchers. Rather than a fad diet, it would help her learn better ways at looking at food options and she might be motivated by the tech part of their online program. I also highly recommend fitbit as an activity monitoring device, both for general health/weight and for diabetes. It really helps me to keep track of when I need higher or lower basals. For example, if my basal is set for an average of 1000 steps an hour and I've done 1000 in 30 minutes just doing normal actiities, I should set a temp basal even though I'm not "exercising." Same for if I've been just sitting around.

    Good luck to both of you, this is a tough one.
     
  8. Jensmami

    Jensmami Approved members

    Joined:
    May 17, 2007
    Messages:
    2,082
    Weight and teenage girls is a very tricky subject. DD was always a heavy girl, on a simple chart she would probably being considered obese. But she eats a very healthy diet and is very active. Her stomach is flat as it can be. No doctor has ever said anything about her weight. And I know if they would, it would crush her. For her that's just her body type, she does not think she does anything wrong.

    Now I know the OPs situation is a little different, however I would be cautious to just go by a chart. This is a sensitive matter, and if not done the right way it can get worse in stead of better. Good luck to the OP and her DD.
     
  9. quiltinmom

    quiltinmom Approved members

    Joined:
    Jun 24, 2010
    Messages:
    1,189
    This is my thought.

    She probably knows she's fat. She may not want to face it, but she probably knows it. And I'd be willing to bet she doesn't like it. She most likely wants to change, but doesn't know how. Add to that being a teenager and diabetes, probably makes her feel completely out of control, and eating is the only thing she can control. So that's where she goes. That's my guess.

    It could also be something other than diabetes, such as thyroid or some other hormone imbalance. I'd explore that if it were my daughter.

    With every problem, it seems that finding out the "why" is the most important first step. I'd sit down with her, not in a finger-pointing way, but in a "I love you and want to help you" way (if it's even possible for a girl her age to percieve a parent as being that way :rolleyes:). I would explain that she can eat, but she just needs to have a shot to cover it. When my DS sneaked food, I tried my best to reassure him that he didn't have to restrict food because of diabetes; he just needed to have insulin to cover it, and he could have a shot any time he wanted. (It seems logical to us, as adults, but it might not be to a child.) She may or may not realize what she's doing to herself. It's also important to help her recognize that a healthy diet is is a healthy diet, diabetes or not. As in, she needs to know that if there are food restrictions, it's not because she has diabetes. That's how I'd handle the diabetes part.

    I know for my 11 year old, not having a pump would be much, much harder. A pump is just a machine, it can't fix your problems, but it definitely makes diabetes management way easier and will most likely make her feel much more normal.

    For the weight part, I would have HER come up with a plan. She will most likely need some guidance in making a good plan (a dietitian or a doctor might come in handy for this stage), but it needs to come from her. Have her choose some goals. It will be better if the goals are connected to behaviors, not numbers on the scale or BG meter. For example, "exercise every day" is better than "lose 20 lbs." She will need you to be there to lovingly encourage her to stick to the plan that she made. (It might help if you do it with her--girls like to do things in teams a lot more than alone.) I think it will go over a lot better than if you say, "here's what you're going to do. Now I'm going to make you do it." You'll probably need to come up with some kind of reward to motivate her to stay on track. Maybe a small reward at the end of each week she sticks to it, and maybe a big reward later on, something like that.

    My last bit of advice is to find a diabetes camp for her to go to. It's a great time for her to see other kids her age dealing with it, not feeling like people are staring at her when she tests her blood, and she can see adults correctly modeling diabetes management. Even my son, who doesn't seem to be that bothered by having D, says he feels different at camp because everyone else there has diabetes. They can truly empathize with him. Imagine what that would do for a person who IS bothered by having it. Plus it's a week of fun! What kid is going to turn that down? lol My DS has gone to camp the last 3 summers and he loves it. It is second only to Christmas for him.

    Good luck! Keep us posted.
     
  10. quiltinmom

    quiltinmom Approved members

    Joined:
    Jun 24, 2010
    Messages:
    1,189

    I love this idea. Instead of saying "you need to eat better" you can frame it as, "I'm bored of all the regular stuff we eat. I need help coming up with some new things. Would you like to help? Let's look online to find some recipes that look really good." That way it's not her fault or some sort of punishment. It's more like something fun the two of you are doing together. And she's learning life skills at the same time. :)
     
  11. danismom79

    danismom79 Approved members

    Joined:
    Apr 21, 2008
    Messages:
    5,300
    Do you know what happened in the time between dinner and the next morning?
     
  12. Mish

    Mish Approved members

    Joined:
    Aug 20, 2009
    Messages:
    1,393
    Guys, not to beat a dead horse here but we're not talking about an older teen with tiny little weight problem. We're talking about a very young girl who weighs 200lbs. There is simply no world in which a person of any age at 5'3" should weigh 200lbs. Forget about the charts. Something drastic has to happen beyond "oh let's make better food choices."

    She needs to be seen by a physician ASAP an enrolled in a physician supervised weight program. Not offered a choice in making meals at this point. Later, perhaps. She's going to be very sick soon if someone doesn't do something drastic.

    Just for reference, look at where 200lbs falls on this growth chart. We're not talking just a simple weight problem here.
    http://www.cdc.gov/growthcharts/data/set1clinical/cj41l022.pdf
     
  13. KatieSue

    KatieSue Approved members

    Joined:
    Oct 5, 2010
    Messages:
    921
    Teens and weight is tricky business. My daughter will go through phases where she gets a bit more pudgy. I try to offer better food choices. If I put out a bowl of cucumbers she'll eat them instead of something else.

    Is it possible to maybe come up with a routine of walking with her daily or some other form of exercise. We try to go for walks and it's also a nice time to have long chats. If you're doing something with her then she may not feel singled out.

    And I do think she needs to see a physician. To be honest our meetings with nutritionists have really not been useful to us, at all. The weight watcher suggestion is great. If the whole family can get on board she won't feel singled out there either.
     
  14. Jensmami

    Jensmami Approved members

    Joined:
    May 17, 2007
    Messages:
    2,082
    I totally understand what you are saying, and I agree something has to be done. I just think you have to be cautious with these charts (body type, fat vs muscles all have an influence on the weight too), according to this chart my DD has been obese for many years (her height and weight has been pretty much the same for the last 4 years) But seeing her, the doctors don't think she is obese.
     
  15. Christopher

    Christopher Approved members

    Joined:
    Nov 20, 2007
    Messages:
    6,771
    Yes, you are kind of beating a dead horse. You made your point in previous posts and to keep repeating it may be painful to the OP and possibly her daughter if she is reading this. Not telling you how to post, just that you may want to dial back the intensity a bit.

    To the OP, you may want to talk to her doctor about Symlin and Victoza. Even though the use of these drugs in people with type 1 under the age of 18 is off label, both can help her lose weight.

    Good luck and I am sorry you are dealing with this. It is a very sensitive issue for a young girl and should be treated as such.
     
  16. Mish

    Mish Approved members

    Joined:
    Aug 20, 2009
    Messages:
    1,393
    Yeah, but it kills me when people keep acting like this is just a pudgy teen issue.
    Someone needs to be blunt about this really. A kid that age dosn't get to 200lbs overnight. What happened when she was simply at the top of the weight chart? Are people so immune to what 200lbs is that a 200lb teen seems like a simple weight problem that can be corrected with asking the kid what she wants to eat?
     
  17. Christopher

    Christopher Approved members

    Joined:
    Nov 20, 2007
    Messages:
    6,771
    Yes, and you have been blunt. Over and over. You are coming across as judgmental, looking to blame someone and not having much empathy for how sensitive an issue this is (not saying that is your intention, just how it may be perceived).
    It is easy (for me at least) to see how things like this can just slowly happen over time and then before you know it, it has become a problem. My point was simply that you made your point and repeating it over and over may not be the most helpful approach. The OP is struggling and may not appreciate such a heavy handed approach. Or maybe she will. Who knows.
     
    Last edited: May 22, 2013
  18. Mish

    Mish Approved members

    Joined:
    Aug 20, 2009
    Messages:
    1,393
    Thanks for your feedback. Unfortunately the OP hasn't even come back to comment, so my points were really to all the other folks who were sort of treating it like just a tiny issue. It really bothers me when I see kids this big. There is no reason, whether that is blame or not, it doesn't happen overnight and someone WAS turning a blind eye - either the parents or the doctors or someone. She's a young kid with a lifetime of bad health ahead of her if she can so easily gain 50lbs in one year. The time for tiptoeing around the issue is long gone. There's a point where you have to be sensitive with a kid and weight. I fully get that. This is not that time. That time, for this kid, was 75 lbs ago.

    In the end, it's not a diabetes situation really and going on a pump isn't going to fix this.
     
  19. Megnyc

    Megnyc Approved members

    Joined:
    Nov 8, 2012
    Messages:
    1,373
    I 100% agree that she is morbidly obese based on her BMI.

    However, this is a kid who could easily withhold insulin and put herself into DKA in a matter of days. I think how the parents handle this is absolutely crucial to prevent that from happening.

    The OP never replied with her daughter's TDD but I would assume she is very insulin resistant. I think this goes far beyond the parents intervening. They need to find out if there is a medical reason for the weight gain and address the issue of the insulin resistance. As I suggested above they need to speak to her endo about adding metformin, symlin, or some other medication to address the presumed insulin resistance as soon as possible. I would think it would be difficult to even formulate a plan to lose weight before they handle the high blood sugars. She has fasting blood sugars in the 400s, of course she is starving all the time.

    Again, I agree there is a major problem here. I think the parents need to get her appropriate medical attention right away. I am just more concerned about the blood sugars and preventing an eating disorder right now then the weight. We don't know her A1C but it sounds like fasting numbers in the 400s are not uncommon. She is either very insulin resistant (my guess) or getting far too little insulin for her weight. I just think the parents talking to her about her weight is only going to upset her (which comes with risks) and not get anywhere until they address the insulin resistance problem.
     
  20. Michelle'sMom

    Michelle'sMom Approved members

    Joined:
    Aug 21, 2009
    Messages:
    1,432
    ^^^this. And whether or not there's a medical issue behind the weight gain, I would suggest a few visits with a counselor. The endo's office would be a good place to get a referral, if there's not someone on the D team.

    To the OP: You're not alone in dealing with weight issues in a CWD. My daughter is 14 & having problems too. It's a difficult & delicate situation, regardless of the cause. Some of the posts here may come across as judgmental, but I believe they come from concern for your daughter.
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice